title: An anterior ankle-foot orthosis improves walking economy in Charcot-Marie-Tooth type 1A patients.
abstract: BACKGROUND
  Ankle-foot orthoses are commonly prescribed in Charcot-Marie-Tooth type 1A disease to improve quality of walking and reduce the risk of falling due to the foot drop.
  
  
  OBJECTIVE
  This study aimed at assessing the effect of an anterior ankle-foot orthosis on walking economy in a group of Charcot-Marie-Tooth type 1A patients.
  
  
  METHODS
  Within-group comparisons.
  
  
  METHODS
  7 Charcot-Marie-Tooth type 1A patients (four women and three men; 37 ± 11 years; age range = 22-53 years) were asked to walk on a circuit at their self-selected speeds ('slow', 'comfortable' and 'fast') in two walking conditions: (1) with shoes only and (2) with Taloelast(®) anterior elastic ankle-foot orthoses. Speed of walking and metabolic cost of walking energy cost per unit of distance were assessed at the three self-selected speeds of walking for both walking conditions.
  
  
  RESULTS
  Speed of walking at the three self-selected speeds did not differ between shoes only and anterior elastic ankle-foot orthoses, whereas walking energy cost per unit of distance at comfortable speed was lower in patients using anterior elastic ankle-foot orthoses with respect to shoes only (2.39 ± 0.22 vs 2.70 ± 0.19 J kg(-1) m(-1); P < 0.05).
  
  
  CONCLUSIONS
  In Charcot-Marie-Tooth type 1A patients, the use of anterior elastic ankle-foot orthoses improved walking economy by reducing the energy cost of walking per unit of distance, thus reflecting a lower level of metabolic effort and improved mechanical efficiency in comparison with shoes only.
  
  
  CONCLUSIONS
  From a practical perspective, Charcot-Marie-Tooth type 1A patients with anterior elastic ankle-foot orthoses can walk for a longer duration with a lower level of physical effort. Improvements in walking economy due to ankle-foot orthoses are likely a consequence of the reduction in steppage gait.
authors.affiliation: Department of Human Movement, Social and Health Sciences, University of Rome Foro Italico, Rome, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Menotti
authors.affiliation: Department of Human Movement, Social and Health Sciences, University of Rome Foro Italico, Rome, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Laudani
authors.affiliation: Unione Italiana Lotta alla Distrofia Muscolare (UILDM), Sezione Laziale, Rome, Italy.
authors.forename: Antonello
authors.initials: A
authors.lastname: Damiani
authors.affiliation: PTP Nuovo Regina Margherita, Rome, Italy.
authors.forename: Teresa
authors.initials: T
authors.lastname: Mignogna
authors.affiliation: Department of Human Movement, Social and Health Sciences, University of Rome Foro Italico, Rome, Italy andrea.macaluso@uniroma4.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Macaluso
mesh_terms: D000328:Adult; D002607:Charcot-Marie-Tooth Disease / Q000150:complications / Q000503:physiopathology* / Q000628:therapy*; D004734:Energy Metabolism / Q000502:physiology; D005260:Female; D061826:Foot Orthoses; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology; D012775:Shoes; D016138:Walking / Q000502:physiology*; D055815:Young Adult
keywords: Rehabilitation of orthoses users; gait; hereditary neuromuscular disorder; oxygen consumption; walking energy cost